Echocardiogram Question

[Tammy]

Has anyone had an echocardio gram WHILE standing? It seems when they hook me up to all the electrods and than while I stand there and wait for them to get their screen ready, they always notice that I have something strange with the read out, but when they have me lay down and actually do the echo, it all seems mostly fine (other than some mild regurgitation on two valves which is apparently normal). So I'm wondering if anyone has had one done while standing and what it showed? Since my symptoms are so much worse when I'm on my feet, I wonder if an echo could be done when I'm upright.

[mkoven]

Dr. fouad at Cleveland does sitting and lying echos, with a radioactive tracer. I think she's comparing blood flow and output and looks for how much blood pools when you chnge positions.

[delphicdragon]

I wish that they did echos while standing or sitting. My murmur is definitely audible in those positions, but when I lie down, it goes away. I think this is due to my EDS and my heart is stretching different ways in different positions. I wish I could get tested upright. I'd love to see what happens with my aorta as it is seen as small lying down....

Sara

[jump]

I am generally a little skeptical of my cardiologist, but he did tell me that doing an echo standing isn't necessary, as the echo is done to determine only if there is structural damage to the heart. This can be seen whether the heart is acting up or not; in other words, an echo isn't used to diagnose POTS or to determine heart rate, it's only used to rule out structural problems. You can have a perfectly normal echo and still be having heart rate problems. Same thing with murmurs -- if the murmur is causing physical damage, it should show up in the echo even if the murmur itself isn't present at the time of the echo.

[juliegee]

Tammy,

I've always had echo's while lying down. I've never even heard of them hooking you up while standing....but what a brilliant idea. I'd love to see what our hearts look like whil standing. Bet those skeptical docs would have new found respect for us wimps :-)

Julie

[flop]

A heart murmur that is only audible when standing up is almost certainly a "benign flow murmur". Heart murmurs are caused by turbulent blood flow in the heart, usually as the flow crosses a valve. (Think of it like the gurgling noise that you get when bathwater swirls down the plug-hole).

Flow murmurs are quite common and are heard when there is fast-flowing blood. They are very common in children (have faster heart rates than adults) and in pregnant women (who have hyper-dynamic circulation). In us POTSies when we stand up our heart rate speeds up - it is this increase in heart rate that causes turbulent blood flow and the audible murmur.

Echos are usually done lying-down on the left side as this brings the heart closer to the chest wall and lets them get the best pictures.

I guess that upright echos would show the increased heart rate (just as shown on ECG traces) and possibly reduced cardiac output but that would be really hard to demonstrate using echo as it is a lot of estimations. I don't know that an upright echo would give any information that the doctors don't have already.

flop

[mkoven]

Flop,

Can you explain hyperdynamic circulation? I've been told I have that, as somewhat separate but related to pots--something about how fast my flood flows????

[flop]

Hyperdynamic circulation is basically when the heart is pumping more blood than usual (more litres per minute being sent round the body). It can be due to either faster heart beats, more forceful heart beats (increased stroke volume) or a combination of both.

Pregnant women have hyperdynamic circulation due to needing to supply the placenta with blood as well as the body's normal demands for blood.

I know that I have a flow murmur that appears when I am standing or if I am anxious (only audible when my HR is about 100 or more). My cardiologist told me not to worry about it.

flop